

How to achieve competencies with virtual simulation

In recent instructional design literature, there is increased discussion of a concept called Cognitive Load Theory. Cognitive Load Theory is the notion that each person has a limited amount of working memory and if they are overloaded with stimuli and/or facts, they will become numb to new information and stop retaining new knowledge.

Cognitive Load Theory provides guidance on how to use virtual simulation effectively. Though making a simulation as realistic as possible is important, certain simplifications can actually improve knowledge retention. Simplifying simulations and targeting key focus areas can actually enhance the learning process. The goal should not be to expose a student to every situation they’ll ever come across in one simulation; it should be to expose them to specific information in a controlled series of experiences that achieve the objectives of the training program.

Avoid the Cognitive Load Conundrum

So how do you engage the learner, ensure a positive experience, and produce true knowledge retention without overload?  Here are a few tips.

  1. Create simulations with manageable nuggets of information – Start with a series of mini-simulations which teach a series of skills. In this way, the trainee can pace out their learning and retain ALL of the information, instead of just bits of it. Instead of creating one simulation encompassing an entire week in a hospital, create dozens of simulations focusing on key skills like conflict resolution, interdepartmental communication, emergency response, and device operation.
  1. Incorporate repeated exposure to simulations into your curriculum – Limiting access to training is a legacy of one-on-one, instructor facilitated curriculum. Why do we need to maintain that cycle? Immersive simulations have the innate benefit of operating in a stand-alone setting while recording trainee results. This removes the requirement of the instructor’s physical presence while training is carried out. No longer do you need to schedule training lab time for your students with a proctor. Instead host your simulations online or install them on personal student laptops so your trainees can run a simulation numerous times to perfect their skills from the comfort of their home.
  1. Create a series of simulations which gradually build knowledge from simple to complex – Knowledge is a product of experience, but it is not born overnight. Simulation is a great medium to establish a foundation for learning. Why not start simple? First, create a basic scenario designed to teach a few small skills. As your students become more adept, increase the complexity of their tasks and incorporate common distractions they will face in the real world. Some lessons require a solid foundation before they can be learned. It is not about creating a simulation that is so hard, only your best performers can complete it. What is more important is creating a series of increasingly difficult simulations to slowly build cognitive skills.
  1. Expose your learner to training concepts before they complete simulated training – Simulation is a great tool to reinforce skills, but it is not in itself a replacement for the classroom. By exposing your learner to the concepts they will need to succeed in the classroom first, you can maximize training efficacy in simulated environments. It is not necessary to replace the classroom with simulated training. A better way is to embed simulations within your curriculum so that they complement traditional educational techniques.
  1. Guide novices, but set advanced learners free – Simulations give you the freedom to introduce digital mentors, instructors, and peers into a simulated environment. Why not use these to orient novice learners? Guides are very important to novice learners and will help them forge their way into new areas of expertise. As your students become more advanced and pursue more complex skills, remove the guide and let them explore on their own. If done right, by the end they should succeed without guidance. Use a guide to avoid overloading novice learners with complex simulations before they are ready and assist rookie performers in meeting their potential.
  2. [Update-03/08/2016] Use a mixture of visual cues and verbal statements to enhance training – In a simulated environment, instructors have the luxury of presenting information to their students in a variety of ways simultaneously. This concept, referred to as the Modality Effect, is important to keep in mind during simulation design. A common way the modality effect is used is by showing a diagram which highlights a certain fact while a narrator simultaneously explains the material on display.  A less common, yet important technique is to add inflection to spoken voices while using visual expression and gestures to enhance the written text. By adding inflection in the way people speak, the simulation becomes more than “just another presentation” and begins to engage the learner. When using this tip, be careful not to present unrealistic situations which conflict expectations or your results may suffer.

Virtual simulation is a great approach to accelerating the growth of your workforce with limited time and budget. As you build simulations for your staff, Cognitive Load Theory helps give perspective of how to build effective virtual simulations. It provides guidance on tailoring simulations to different skill groups and adapting them to a student’s current needs. Virtual simulation can be effective and is well suited to meeting these needs.


Thanks for reading. Please share with colleagues who might find value. This post was authored by Discovery Machine, creators of RESITE® for Healthcare. RESITE enables healthcare professionals to quickly and easily create realistic training scenarios for their healthcare trainees—complete with digital doctors, nurses, patients, medical equipment, beds, rooms—everything found in a hospital setting. RESITE places trainees into an immersive 3D environment that helps them learn faster and see the cause/effect relationship of their decisions and hands-on interaction in real time. With over 16 years in the industry Discovery Machine delivers powerful, proven technology with a friendly, accessible front-end that translates to successful training programs empowered with intelligent interaction. For more information about RESITE for Healthcare, please visit Discovery Machine online or call 570-601-3226.


Fraser, A., Ayres, P., & Sweller, J. (2015). Cognitive Load Theory for the Design of Medical Simulations. Simulation in Healthcare, 10(5), 295-307.